Teething: Basics, Symptoms and Signs

Your baby's teeth will make their grand, grumpy entrance between 3 and 12 months old or later. Here are some common signs your little one is teething, along with remedies that will ease baby's discomfort.

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When your baby's first tooth shows up, you might be taken by surprise ("Ow! Was that just a bite?"), or you might just finally understand what all those teething signs — drooling, night waking, crabbiness — were about. Every baby experiences teething differently: Some have virtually no symptoms, while others experience teething pain for months. Fortunately, there are some signs to watch for as this developmental milestone approaches that can help make teething easier for your baby — and for you.

When Do Babies Start Teething?

Teething symptoms can precede the actual appearance of a tooth by as much as two or three months. Most babies get their first tooth around 6 months old, though there's a wide range in when those first tiny pearly whites make their appearance. Some infants' first teeth erupt as early as three months old, while others don't get theirs until after the first birthday.

In What Order Do Baby Teeth Appear?

The most common first teeth are the two in the bottom center of the mouth, followed by the two in the top center. Then the pattern typically goes outward with the lateral incisors, which are in the next spot over, followed by the first molars, or the molars closest to the opening of baby's mouth. After that come the canines on either side of the lateral incisors and last are the second molars in the very back.

9 Common Teething Symptoms

How do you know if your baby is teething? What symptoms should you look out for? Your little one is not likely to understand why he feels so achy, wakes up with soreness in his mouth or is bothered by an itchy chin. Here are the top teething symptoms to keep an eye out for:

Drooling. It's hard to believe so much fluid can come from the mouths of tiny babes, but teething stimulates drooling, and the waterworks are on for many babies starting from about 10 weeks to three or four months of age or older. If you find that your baby's shirts are constantly soggy, fasten on a bib to keep her more comfortable (and cleaner), and gently wipe her chin throughout the day to stave off chapping.

Teething rash. If your teething baby is drooling, the constant drip may cause chafing, chapping, redness and rashes around her mouth and chin (and even on her neck). Patting it away will help prevent her skin from taking a hit. You can also create a moisture barrier with Vaseline or Aquaphor, and moisturize with a gentle, unscented skin cream as needed. Have some nursing cream (like Lansinoh) on hand? It's great for protecting tender baby skin, too.

Coughing and/or gag reflex. All that drool can make babies gag and cough (you'd choke too with a mouthful of spit). But it's not cause for concern if your baby has no other signs of cold, flu or allergies.

Biting. Pressure from teeth poking through under the gums causes baby a lot of discomfort — which can be relieved by counterpressure (aka chewing and biting). Teething babies will gum whatever they can find, from teething rings and rattles to your soon-to-be sore nipples (if you're breastfeeding) and fingers.

Crying. Some babies breeze through teething with nary a whimper, while others suffer from a good deal of pain due to the inflammation of tender gum tissue — which they feel compelled to share with you in the form of whining or crying. First teeth usually hurt the most (as do the molars, because they're bigger), although most babies eventually get used to what teething feels like and aren't quite so bothered later on. Talk to your doctor about when to offer pain relievers like infant acetaminophen.

Irritability. Your baby's mouth will ache as that little tooth presses on the gums and pokes up to the surface, and, not surprisingly, it'll probably make her feel out of sorts. Some babies may be irritable for just a few hours, but others can stay fussy for days or even weeks.

Refusal to feed. Uncomfortable, cranky babies yearn to be soothed by something in their mouths — whether a bottle or the breast. But the suction of nursing may make a teething infant's sore gums feel worse. For that reason, teething babies can be fussy about feedings (and get more frustrated as neither their discomfort nor their hungry tummies find relief). Those eating solid foods may also refuse to eat while they're teething. Keep at it, and call your pediatrician if the strike lasts more than a few days.

Night waking. The teething fairy doesn't only work days. As your baby's little chompers begin to emerge, her discomfort may disrupt her nighttime slumber (even if she previously slept through the night). Before offering comfort, see if she can settle herself back to sleep; if she's still restless, soothe her with patting or lullabies but avoid a return to overnight feedings (which will come back to haunt you when this phase has passed).

Ear pulling and cheek rubbing. Babies whose teeth are coming in may tug furiously at their ear or rub their cheek or chin. The reason? Gums, ears and cheeks share nerve pathways, and so an ache in the gums (especially from erupting molars) can travel elsewhere. (Babies with ear infections will also yank on their ears, so check with your pediatrician if you suspect your little one may be bothered by more than just teething.)

The type and severity of these symptoms vary widely from baby to baby — for one, teething means lots of pain and big-time tears, while another might breeze right through to a mouth full of teeth without a complaint. But you can probably expect to see at least some, and maybe many, of these symptoms. Hang in there, Mom!

The 8 Best Teething Remedies

Chewing. Teething babies love to chew, and for good reason: The gumming action provides counter-pressure, which relieves the aching of new pearly whites pushing up and out into the mouth. Bumpy rubber teething rings, rattles and other chewy, soft toys work well (including, as your baby has probably figured out, the plastic bumper on a crib rail). Chewing is even more effective when the object is cold and numbs the gums. Keep a supply of teething toys or wet washcloths in the fridge, rather than the freezer — very cold comfort can hurt sensitive gums just as much as an erupting tooth does.

Counterpressure. Your clean finger, teething toys with nubbly edges or a soft, wet toothbrush (no toothpaste) rubbed firmly on baby's gums can provide the same soothing counterpressure as teething rings and wet cloths. Your baby may balk at first because it might hurt initially, but it soon brings relief.

Cold drinks. A bottle of cold water can offer chilly relief to achy gums for babies over six months (when water can be introduced). If baby doesn't take a bottle, you can give (ice-free) water in a cup.

Cold food. Refrigerated food such as yogurt, blended peaches and applesauce (once they've already been introduced to your baby) can be more appetizing than warm or room temperature treats, and can ease achy gums. Or give frozen fruits like bananas and plums in a baby feeder mesh bag (so large chunks of food can't pose a choking risk), but only under adult supervision and with baby sitting or propped upright.

Pain relief. If chewing, rubbing and sucking chilly foods don't do the trick, break out the baby acetaminophen — but only after checking with your pediatrician.

Comfort. Extra snuggles, kisses and lots of patience are what a teething baby craves.

Avoid numbing agents. Using rubbing alcohol on your baby's gums is a no-go, and the Food and Drug Administration (FDA) also warns against using topical numbing agents, which can put children under age 2 at risk for reduced oxygen levels in the blood. The FDA also says parents should avoid any herbal or homeopathic teething gels and other meds, especially since some contain an ingredient that can cause heart problems and drowsiness.

Avoid amber teething necklaces. There's no medical evidence to suggest that amber teething necklaces work, and most pediatricians advise against them, in large part because they can pose a choking hazard.

Consider This: A Teething Mitt

Your baby will probably realize very quickly that chewing on the nearest object — whether that’s his or her own fingers, a toy or something less-than-ideal, like your cell phone — helps relieve teething pain. Give him or her something safe to chew on so he or she doesn’t pick up a dirty toy or potential choking hazard. Good teething toys are made of soft, BPA-free plastic, rubber, cloth or wood and are too large to pass through a toilet paper tube.

Why We Love It: Like most toys you give baby, teethers are only useful for as long as your baby has it in his or her hands. Thankfully, your baby can’t drop the Yummy Mitt Teething Mitten while you’re rolling around town in the stroller.The mitten is secured over baby’s hand with Velcro, so it stays on to comfort baby for longer. The textured silicone and breathable cotton give baby a range of materials for baby to try out, and between uses, the whole mitt is machine washable, so you’ll always know you’re giving baby a safe toy to chew on.$15 on Amazon

What Moms Are Saying: "Absolutely love that baby can enjoy it himself. The colors are vibrant and the raised teething edges are perfect."

What not to worry about: Teething can cause bleeding under the gums, which may look like a bluish lump in baby's mouth. It's nothing to be concerned about and can be relieved with a cool, wet washcloth.

While some parents swear that low-grade fever and diarrhea are teething symptoms, doctors are divided on whether that's true. But like inflammation anywhere else in the body, inflamed gums can sometimes produce a low-grade fever. So if your little one does develop a temperature of under 101 degrees while she's cutting a tooth, it could be caused by swelling of the gums and isn't anything to worry about. If the fever continues for more than three days, if it's higher than 101 degrees or if it's accompanied by any other symptoms of illness, call your pediatrician.

The same goes for diarrhea, which some parents speculate can be caused by all the extra drool that gets swallowed when a baby is teething. It's not cause for concern, either, but if it lasts for more than two bowel movements, give your child's doctor a call.

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect the First Year. Health information on this site is based on peer-reviewed medical journals and highly respected health organizations and institutions including ACOG (American College of Obstetricians and Gynecologists), CDC (Centers for Disease Control and Prevention) and AAP (American Academy of Pediatrics), as well as the What to Expect books by Heidi Murkoff.

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